Your insurance policy is a contract that exists between you and your insurance company. Our relationship is with you, the patient and not the insurance company. If you have questions about your policy, please call the phone number provided on the back of your insurance card. The patient or responsible party is responsible for their bill being paid in full. Please inform us at every visit of any changes to your insurance coverage.
COPAYMENTS: It is a requirement of your insurance company that we collect your co-pay.
Payment is required upon checkout.
DEDUCTIBLES & CO-INSURANCE: If you are a NEW OR EXISTING PATIENT a $175 deposit will be collected at the time of the visit which will apply towards your deductible and co-insurance. Any remaining balance after submission to your insurance company is your responsibility. Medicare patients are not required to pay the $175 deposit fee.
SELF-PAY: Full payment is due at time of service. At a minimum, an evaluation and management fee will be charged. Additional procedures/services may be recommended by the doctor but you will be informed of these charges before proceeding with treatment.
REFERRAL: If your insurance plan requires a referral from your primary care doctor, this will be required at the time of your visit. Without a referral available, we may need to reschedule your appointment.
NO SHOW: 24 hours notice is required for cancellation of your appointment and failure to do so will incur a $25 fee. Failure to provide 24 hours notice of a procedural visit will incur a $50 fee.
FMLA/DISABILITY/MEDICAL RECORDS: There is a $25 charge for completion of these forms. There is a $25 fee to obtain a copy of your medical records. There is a charge of $15 for an x-ray disk.